Latest UK HIV statistics: 42% of diagnoses are late and disparities in care continue by ethnicity

9 October 2025. Related: Special reports, Other news.

Simon Collins, HIV i-Base

On 7 October the latest HIV surveillance report was published online by UKHSA, together with seven updated datasets. [1]

The report covers statistics on HIV testing, PrEP, new diagnoses and other HIV-related care outcomes from sexual health clinics up until December 2024, with demographics based on England.

The breakdowns include inequalities in care outcomes, including in ethnically minoritised populations. These are complex results, including by country of birth. However the group that still had the highest rate of declining an HIV test was white people born in the UK (at 29%).

Despite challenging conditions, HIV testing has increased, with opt-out testing in emergency departments proving incredibly successful, now accounting for 8% of new diagnoses.

However, rates of late diagnosis remain high with 42% diagnosed with a CD4 count <350, even after adjusting for acute infection.

Trend data is reported for the last five-year period but this needs to be interpreted to allow for the impact of COVID from 2020.

One major change in the methodology this year is to only highlight HIV diagnoses for people who first test HIV positive while in the UK. This is explained as “data exclude people diagnosed before continuing their HIV care in England”. This change avoids the political outcry that occurred last year when the 51% increase in new diagnoses was due to people travelling to the UK whom already knew they were living with HIV, many of who were already on treatment. [2]

Selected highlighted results are listed below but please refer to the full report and datasets for details.

HIV testing

Overall there was a slight increase in HIV testing (3%) but with higher increases in many Black and other ethnically minoritised groups.
HIV positive rates were also higher in ethnically minoritised groups.
High uptake of partner notification (85%, 830/975) with 5% (43/830) leading to partner diagnoses.

PrEP and PEP

Over 111,000 people accessed oral PrEP in 2024, a 7% increase compared to 2023.
Approximately 10% of people attending clinics were categorised as being at high risk for HIV, of whom 76% accessed PrEP.
PrEP access by those at high risk was highest in gay and bisexual men (79% white and 78% ethnically minoritised) and significantly lower in Black African heterosexuals (35% women and 36% men), and among other ethnically minoritised heterosexuals (44%).
Overall, 8463 people were prescribed PEP at a sexual health clinic. This was a 21% and 16% increase in heterosexual women and men, respectively and a 2% increase in gay and bisexual men.

New Diagnoses

There were 3,043 new HIV diagnoses in the UK in 2024, reported as a 4% decrease from 2023. Although not highlighted, it looks like another 2,525 people (compared to 3198 last year) tested HIV positive who had already been diagnosed in another country first.
Opt-out testing for bloodborne viruses (BBVs) in emergency departments accounted for 8% of all new HIV diagnoses in 2024.
Diagnoses in England decreased by 6% from 859 in 2023 to 810 in 2024 (by 6% in white men vs 2% in ethnically minoritised men).
Between 2023 and 2024, new HIV diagnoses in England among Black African heterosexual men increased by 15% (231 to 265) but decreased by 5% among Black African heterosexual women (441 to 418).

Late HIV diagnoses and mortality

Late diagnosis (CD4 <350) in England was reported in 42% (928/2,196). However, the denominator is only the 79% of new diagnoses that had a CD4 count reported within 91 days of diagnosis. This shows that more than 1 in 5 new diagnoses are not routinely supported with a CD4 result.
The median overall CD4 count was 359 cells/mm3.
Rates in heterosexuals were 52% and 46% for men and women, respectively, vs ~30% in gay and bisexual men.
Late diagnosis was associated with a 10-fold higher risk of mortality in the first year.
All-cause mortality fell by 14% (from 751 to 643) with reductions in all groups except African women (14% increase from 69 to 79).

Overall outcomes

England now reports UNAIDS targets of 95:99:98. However, the denominators for these targets are the numbers of people accessing care during the previous year, with no allowance for people who disconnect from care.
The majority of people living with HIV are now older than 50 (52%) (53,734/103,689).
Viral suppression on ART was significantly lower in the 15-24 year old group – only 91% (1,233 of 1,351) vs 99% in people older than 65.

comment

These surveillance data are essential to understand effectiveness of HIV testing, treatment and prevention programmes at difficult times. The UKHSA team should be recognised for the consistent quality of this work, although some of the data in terms of changing denominators are difficult to understand. The decision to no longer report data for people who had previously been diagnosed outside the UK has not yet been widely reported.

Rates of diagnoses in people born abroad (outside the UK) are much lower than equivalent figures for many EU countries where ECDC/WHO data report this at over 65% in France. Slovenia, Cyrus, Czechia, Finland, Luxembourg, Belgium, Netherlands and Denmark which increases to over 9o% in Sweden, Norway, Ireland and Iceland.

Although the results show the impact of some successful policies, they also continue to report significant differences in care for ethnically minoritised populations, especially over access to PrEP.

High rates of late diagnosis are still reported in all groups.

The narrative describing PrEP access should however be updated to reflect the 2025 BASHH/BHIVA guidelines which broaden access to PrEP to all, rather than just those at high risk.

Although data on transgender and non-binary people are now collected, the tables (37 to 39) still use incorrect and confusing language. This is the third year that i-Base has raised this but the contradictions that limit how this important data can be interpreted have still not been changed.

References

UK Health Security Agency, London (UKHSA). HIV testing PrEP new HIV diagnoses and care outcomes for people accessing HIV services: 2025 report. The annual official statistics data release (data to end of December 2024). October 2025.
https://www.gov.uk/government/statistics/hiv-annual-data-tables
HTB. HIV diagnoses in England jump by 51% in 2023: missing targets and highlighting disparities in access to care. HTB (06 October 2024).
https://i-base.info/htb/48896